A stuffy nose is one of the more uncomfortable symptoms of a cold or the flu. Decongestants are over-the-counter medications used to relieve nasal congestion. Some are taken by mouth, while others are sprayed into the nose. Afrin is a brand of oxymetazoline spray, a topical nasal decongestant. Afrin provides temporary relief from nasal congestion, but using it can lead to side effects such as nasal irritation, dryness and sensitivity. The medication can also be absorbed into the body and may not be safe for people with certain medical conditions. Using Afrin more frequently or longer than directed can also cause ongoing nasal stuffiness.
With a cold or the flu, inflammatory chemicals produced by the immune system cause dilation of the blood vessels inside the nose, swelling of the nasal tissues and increased mucus production. These effects lead to nasal congestion. Afrin's active ingredient, oxymetazoline, provides relief by constricting the nasal blood vessels for up to 12 hours. The resulting decreased blood flow relieves swelling and nasal congestion. However, prolonged constriction of the blood vessels can lead to uncomfortable nasal dryness, according to the 2004 medical text "Pharmacology Application in Athletic Training." In some cases, this dryness may lead to painful cracks in the tissue lining the nose and possible bleeding.
The manufacturer's directions note that Afrin should not be used for more than 3 days. Using Afrin beyond the recommended time can cause rebound congestion, a state of severe nasal swelling and congestion unrelated to a cold or flu but specifically from medication overuse. According to a February 2004 study published in the journal "Annals of Otology, Rhinology and Laryngology," use of oxymetazoline spray for longer than 3 days can lead to complex changes in the nasal lining with an increase in mucus-producing cells and a decrease in the ability to clear mucus from the nose. The difficulty clearing nasal mucus contributes to ongoing congestion.
Increased Nasal Sensitivity
Overuse of topical nasal decongestants like Afrin can lead to increased nasal sensitivity to irritants, notes the 2016 medical text "Basic Clinical Radiobiology." Common irritants include tobacco smoke, fragrances, cleaning chemicals and airborne allergy triggers like pollen, mold and pet dander. Repeated stimulation of the nasal vessels into constriction promotes the release of inflammatory chemicals that can increase nasal sensitivity and symptoms, including nasal congestion, sneezing and itchiness inside the nose.
Prolonged use of Afrin beyond the recommended 3 days can also lead to rhinitis, warns the 2009 text "Rhinology and Facial Plastic Surgery." Rhinitis refers to inflammation of the tissues inside the nose, leading to redness, swelling and increased fragility. Rhinitis due to overuse of nasal decongestant spray is caused by repeated constriction of the nasal blood vessels. To compensate, the blood vessels become less responsive to the medication and open widely as the medicine wears off. This rebound dilation of the nasal blood vessels and related tissue swelling lead to ongoing stuffiness. The fragile tissue inside the nose may crack and bleed, leading to nose bleeds or blood-tinged mucus with nose blowing.
Warnings and Precautions
While the medicine in Afrin spray stays primarily in the tissues lining the nose, some can be absorbed into the bloodstream. This can lead to constriction of blood vessels and other effects in various parts of the body. This can be potentially dangerous in people with certain illnesses. Talk with your doctor before using Afrin if you are pregnant or breastfeeding, or if you have:
-- High blood pressure.
-- Heart disease.
-- Enlarged prostate.
-- Thyroid, kidney or liver disease.
- Basic Clinical Radiobiology, Seventh Edition; Michael Gleeson et al.
- Annals of Otology, Rhinology and Laryngology: Mucosal Changes in Rhinitis Medicamentosa
- Pharmacology Application in Athletic Training; Brent C. Mangus and Michael G. Miller
- Rhinology and Facial Plastic Surgery; Fred J. Stucker et al.
- DailyMed: Afrin Original - Oxymetazoline Hydrochloride Spray
- Journal of Investigational Allergology and Clinical Immunology: Rhinitis Medicamentosa